What is Cervicogenic Vertigo?
Vertigo and dizziness are often used interchangeably, but these debilitating physical conditions are slightly different. Vertigo is a sensation many describe as the feeling of your body moving through space. Dizziness is the sensation of the room moving around you. Vertigo is a type of dizziness, but not all dizziness is Vertigo.
It’s estimated that 40 percent of U.S. adults will experience Vertigo at least once in their lifetime, with women slightly more likely to get it than men.
There are different types of Vertigo. The most common types include Central Vertigo (sometimes seen after trauma) and Peripheral Vertigo (the most common type being BPPV – or Benign Paroxysmal Positional Vertigo). In most instances, Vertigo is caused by a malfunction within the inner ear. Improper information is relayed to the brain, causing it to perceive that the body is tipping or moving when it is not.
Vertigo can also arise as a viral symptom or other conditions like diabetes or a stroke.
Cervicogenic Vertigo is differentiated by the presence of neck pain in addition to Vertigo. This neck pain is usually located in the upper portion of the neck near the suboccipital region (base of the skull).
Causes of Cervicogenic Vertigo
The exact cause of Cervicogenic Vertigo is unknown, but several theories have been proposed over the years regarding the mechanisms behind this condition.
- Barre-Lieou Syndrome: This hypothesis proposes that incorrect input from the nerves in the cervical spine could cause vasoconstriction, leading to less blood flow to areas of the inner ear. The lack of blood flow then leads to symptoms of Vertigo.
- Proprioceptive Cervical Vertigo: In this proposed pathophysiology, damage to the joint receptors of the upper cervical spine sends invalid information to the Vestibular nuclei of the brainstem, resulting in Vertigo. Traumatic injuries like car accidents and whiplash injuries often result in this proprioceptive disorder.
- Rotational Vertebral Artery Vertigo: This proposed hypothesis states that rotation of the head can cause occlusion (blockage) of the vertebral artery that travels up through the cervical vertebrae. The lack of blood flow results in symptoms of Vertigo.
- Migraine-Associated Cervicogenic Vertigo
Neck pain and Vertigo symptoms are often present in conjunction with migraine pain. It has been proposed that the Cervical Vertigo symptoms are a product of migraine pain.
Barre-Lieou Syndrome and Rotational Vertebral Artery Vertigo have been ruled out over the years, leaving Proprioceptive Cervical and Migraine-Associated Cervicogenic Vertigo to help us understand the potential causes of Cervicogenic Vertigo.
A study performed by Thompson-Harvey et al. investigated the symptoms reported by patients with Cervicogenic Vertigo and compared them to the symptoms reported by those suffering from migraines and other types of Vertigo. They found a significant overlap in the reported symptoms of Cervical Vertigo and migraines, further lending weight to the theory that Cervicogenic Vertigo may be a subgroup of migraines.
It can often be seen in people who have been in motor vehicle accidents or other traumatic incidents involving the head’s whiplash action.
Common Symptoms of Cervicogenic Vertigo
Cervicogenic Vertigo is a form of dizziness that is related to pain in the neck. Generally, the neck pain is located at the top of the neck under the occipital region. This area houses many essential muscles, including the insertion points of the trapezius, levator scapulae, and the suboccipital muscle group.
The location of the C1 and C2 cervical vertebrae also plays a significant role in the rotation and lateral flexion of the head and neck.
Try This: To find the occipital region, take your hand and run it down the back of your skull until the skull bones fall away and you feel muscle under your fingers.
Cervicogenic Vertigo is a diagnosis by exclusion, meaning that someone is suffering from Vertigo and neck pain. It also does not have the symptoms and positive tests that classify it as a different type of Vertigo or a cervical spine condition. Patients with this disorder will often present with pain in the upper part of the neck and tight muscles in the surrounding area. Many experiences a reduction in the range of motion of the neck. Additionally, many patients will also complain of ancillary migraine symptoms.
In addition to presenting with neck pain and Vertigo, patients may have hypertonic (tight) neck muscles. The cervical range of motion in these individuals tends to be limited. It is not uncommon to experience headache pain in conjunction with this condition. Diagnostic imaging can be performed to identify further the underlying cause of the neck pain and Vertigo.
The Best Treatment Options for Cervicogenic Vertigo
Treatments for this condition can vary depending on the baseline structures involved in causing the pain and Vertigo. A 2021 study from China suggests a multi-disciplinary approach to treatment was effective in diagnosing and treating Vertigo. This integration of disciplines resulted in heightened patient satisfaction, accuracy in diagnosis and treatment, and reduced costs.
These findings are aligned with the emerging approach to diagnosing and treatment of Vertigo and dizziness. Chiropractic care is an integral component of this integrated approach.
For patients experiencing Cervicogenic Vertigo after a traumatic event, as we see in the Proprioceptive Cervical Vertigo, Chiropractic treatments provide profound relief.
If you’ve been suffering from Vertigo, give us a call. Dr. Hoch will perform a complete evaluation to determine if chiropractic is the right treatment for you.